PROOF OF INSURANCE (2025)Page 1 of 1
w � OAS DATE (MM/DD/YYYY)
CERTIFICATE LIABILITY 07/31/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT. If the certificate holder is an ADDITIONAL. INSURED„ the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed,
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT 1-877-945 Center
WTW Certificate
NAM-,E ..... ,�. ..__ .. ..... _,,, .... _., .... __ ._.
Willie of New Jersey, Inc. 2378
pg10NE ,...J4X
c/o 26 Century Blvd (M, ri w x p C No 7
E-MAIL @wt8 co . com
1-8
P.O. Box 305191 A)ODRE eertificates737w� -,. „
Nashville, TN 372305191 USA i NAIC4
INSURERS) AFFORDING COVERAGE„
INSURER 22
......
Mitsui Sumitomo Insurance USA Inc 551
INSURED INSURERB: Mitsui Sumitomo Insurance Company of Ameri_ 20362
Berlitz Corporation
Princeton, NJ08540 NNSURER,,.O .......... .�......°...,___ .�. .. .....m _--. _ ....... �.. ..
7 Roszel Road INSURER
D..._ ... ......... ,.... .._...
INSURER F:
'OVERAGES CERTIFICATE NUMBER. W34392979 REVISION NUMBER,
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Tq m TYPE OF INSURANCE 'AODLSU ER. POLICY NUMBER IMOKDD/ XYY MMDDrY X LIMITS
X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,00
%�A rr -T4I °M5" 1 000,00
_ CLAIMS -MADE t„!7%OCCUR EI(.,(E
Any one person) 10,00
A MED XP
Y PKG3000272 OS/OS/2024'OB/01/2025-
9i 1 AGGREGATE 'TC LIMIT APPLIES PER:
PRO- ✓�'CLOC
POLICY L� JECT
07I•aER:
PERSONAL & ADV INJURY m $ 1,000,000
OENERALAGGREGAT E 1 $ 2 000 000
... O 1, 000, 000
PRODUCTS-COMP/O 0.0....
P AGG $
Is
-SINGLE
AUTOMOBILE LIABILITY
OPIBINEOLIMIT $ 1,000,000
,
ANY AUTO
BODILY INJURY (Per person) ) $
B
'OWNED SCHEDULED BvR8302170 08/01/2024
�,,,,.__.
08/01/2025 BODILY INJURY (Per accident) fi
AUTOS ONLY AUTOS
�e HIRED NON -OWNED
I PRO FERTYDAMAGE $
,( AUTOS ONLY AUTOS ONLY )
e ,kPq 0"�� !!"pl1 ...
Is
X ELLA
CCURRENCE 10,
EACH --
A
i EXCESS LIABIAB CCA MR•R 9AGIE umB5500107 08/01/2024
C
$...
08/01/2025 o- AGGROGA7E 10 000, 000
_
I DE rJ x� RETENTIONS 10,000
$
WORKERS COMPENSATION
X SATUTE ER
AND EMPLOYERS' LIABILITY
B'ANYPROPRIETOR/PARTNERlEXECUTIVE �Y�E.L.
�OFFIC' No N / A WCP9001200 08/O1/2024
........I
. E. L. EACH ACCIDENT S 000
08/01/2025
EXCLUDED. p
E L DISEASE EA EMPLOYEE $p 1 000 000
,(Mandatory In NH)
11 11
II es, describe under
neenoier,n., a nnennrinnie aAin,.
E.L. DISEASE - POLICY LIMIT $ 1, 000,000
,
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
It is agreed that City of EL Segundo, the officers, officials, employees and volunteers are included as Additional
Insureds as respects to General Liability policy. It is further agreed that such insurance as is afforded shall be
primary and non-contributory with any other insurance in force for or which may be purchased by Additional Insureds.
TION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
City of EL Segundo
350 Main Street P 0- 3
El Segundo, CA 90245
m 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
sR xD: 26248919 BATCH: 3563630
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